COCN MCQ — Questions and Answers
Question 1: Which of the following best describes a healthy stoma?
- Pale and dry
- Dark and sunken
- Moist and pink (Correct answer)
- Blue and crusted
Correct answer: Moist and pink
A healthy stoma should appear moist, shiny, and pink or beefy red, similar to the mucous membrane inside the mouth. This indicates good blood supply and tissue viability. Any deviation, such as paleness, dryness, or a dark/blue color, could signal complications and requires further assessment.
Question 2: What is the most appropriate action if the patient reports frequent pouch leakage?
- Ignore unless skin irritation occurs
- Change brands of adhesive remover
- Reassess pouching system fit (Correct answer)
- Use alcohol wipes more frequently
Correct answer: Reassess pouching system fit
Frequent pouch leakage is a common and distressing issue for ostomy patients, often indicating an improper fit of the pouching system. The most appropriate action is to reassess the stoma size, shape, and peristomal skin contour to ensure the barrier opening is correct and the system adheres securely. A well-fitting system is crucial for preventing leakage and protecting the skin.
Question 3: Which material is typically used in ostomy skin barriers?
- Silicone sealant
- Hydrocolloid (Correct answer)
- Rubber latex
- Paper tape
Correct answer: Hydrocolloid
Hydrocolloid is the most common material used in ostomy skin barriers due to its excellent adhesive properties and ability to absorb moisture. This material protects the peristomal skin from effluent, promotes a secure seal, and can even help heal irritated skin. Its flexibility and skin-friendly nature make it ideal for long-term wear.
Question 4: What should a nurse monitor in the first 24 hours after a new stoma surgery?
- Facial symmetry
- Range of motion
- Stoma color and output (Correct answer)
- Blood sugar level
Correct answer: Stoma color and output
In the immediate 24 hours post-surgery, it is critical to closely monitor the stoma's color and the nature of its output. A healthy stoma should be pink or red and moist, indicating good blood flow; any pallor or dusky color could signal ischemia. Monitoring output helps assess bowel function and identify potential complications like obstruction or excessive fluid loss.
Question 5: What tool is used to measure the stoma for proper appliance fitting?
- Ostomy chart
- Caliper
- Measuring guide (Correct answer)
- Blood pressure cuff
Correct answer: Measuring guide
A specialized measuring guide, often provided by ostomy product manufacturers, is used to accurately measure the stoma's diameter and shape. This precise measurement is crucial for cutting the skin barrier opening to the correct size, ensuring a snug fit that protects the peristomal skin from effluent and prevents leakage. Regular remeasurement is necessary as stoma size can change over time.
Question 6: Which nutrient is most important for wound healing around a stoma?
- Caffeine
- Protein (Correct answer)
- Starch
- Cholesterol
Correct answer: Protein
Protein is a fundamental nutrient essential for all stages of wound healing, including around a stoma. It provides the building blocks for tissue repair, collagen synthesis, and immune function, all critical for healthy skin and stoma integrity. Adequate protein intake supports cellular regeneration and helps prevent complications like skin breakdown.
Question 7: What is the purpose of a belt with an ostomy pouching system?
- To carry personal items
- To compress the abdomen
- To secure the pouch and prevent leakage (Correct answer)
- To provide electric stimulation
Correct answer: To secure the pouch and prevent leakage
An ostomy belt is designed to provide additional security and support to the pouching system, helping to keep the skin barrier firmly in place against the abdomen. This added pressure can improve the seal, especially for active individuals or those with irregular abdominal contours, thereby reducing the risk of leakage and extending wear time. It is not meant for compression or carrying items.
Question 8: Which of the following can contribute to peristomal candidiasis?
- Dry skin
- Overexposure to sunlight
- Excessive moisture (Correct answer)
- Daily soap washing
Correct answer: Excessive moisture
Peristomal candidiasis, a fungal infection, thrives in warm, moist environments. Excessive moisture around the stoma, often due to leakage from an ill-fitting pouch or inadequate skin drying, creates ideal conditions for yeast growth. Maintaining dry, clean peristomal skin is crucial for preventing this common complication.
Question 9: What is the recommended action if the stoma retracts below skin level?
- Use a flat barrier
- Apply powder only
- Switch to a convex barrier (Correct answer)
- Discontinue pouch use
Correct answer: Switch to a convex barrier
If a stoma retracts below skin level, a convex skin barrier is recommended. Convex barriers have a dome shape that gently presses into the peristomal skin, pushing the stoma outward and creating a better seal. This helps to prevent effluent from seeping under the barrier and irritating the skin, which is a common problem with retracted stomas.
COCN MCQ
Which of the following best describes a healthy stoma?